Funeral, Cemetery,
Cremation, Burial; Printable Final Arrangements Planning Form #2
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FUNERAL, CEMETERY, CREMATION AND BURIAL PLANNING PAGES [2 of 3]
(Your
Printer Should Printout From 4 to 5 pages)
MY Special & Financial Information Forms
MY Special Information |
|
|
|
For Social Security Claims.
I have
this Information |
Social Security Number |
Yes |
No |
Marriage License |
Yes |
No |
Eligible Child's Birth Certificate |
Yes |
No |
W-2's Last Two Years |
Yes |
No |
Widow's proof over 62 |
Yes |
No |
Death Certificate |
No |
Special Arrangements I Have Also
Made |
Yes |
No |
Contact for Information |
Documentation Location, Description & Notes |
Long Term Care |
___ |
___ |
____________________ |
______________________________ |
Power Of Attorney |
___ |
___ |
____________________ |
______________________________ |
Healthcare Power Of Attorney |
___ |
___ |
____________________ |
______________________________ |
Guardian & Custodian |
___ |
___ |
____________________ |
______________________________ |
Do Not Resuscitate Directive |
___ |
___ |
____________________ |
______________________________ |
Living Will |
___ |
___ |
____________________ |
______________________________ |
Other Arrangements |
___ |
___ |
____________________ |
______________________________ |
MY Financial Information
My Documents Location |
|
|
|
|
Where |
|
Where |
Mortgage |
Other Title 1(?) |
Other Mortgage 1(?) |
Other Title 2(?) |
Other Mortgage 2(?) |
Other Title 2 (?) |
Deed or Notes 1 (?) |
Safety Deposit Box |
Deed or Notes 2(?) |
Will |
Deed or Notes 3(?) |
Children's Birth Certificates |
Income Tax Returns |
Banks, Investments |
|
|
|
|
Account/Item Type |
Location |
Account Number |
Memo/Description |
1) |
__________________ |
_______________ |
________________ |
_______________________ |
2) |
__________________ |
_______________ |
________________ |
_______________________ |
3) |
__________________ |
_______________ |
________________ |
_______________________ |
4) |
__________________ |
_______________ |
________________ |
_______________________ |
5) |
__________________ |
_______________ |
________________ |
_______________________ |
6) |
__________________ |
_______________ |
________________ |
_______________________ |
7) |
__________________ |
_______________ |
________________ |
_______________________ |
8) |
__________________ |
_______________ |
________________ |
_______________________ |
9) |
__________________ |
_______________ |
________________ |
_______________________ |
10) |
__________________ |
_______________ |
________________ |
_______________________ |
Other Financial Matters |
|
|
Account Number if Applicable |
Description/Disposition |
IRA |
Yes |
No |
____________________________ |
__________________________ |
Roth IRA |
Yes |
No |
____________________________ |
__________________________ |
401K Plan |
Yes |
No |
____________________________ |
__________________________ |
Keogh |
Yes |
No |
____________________________ |
__________________________ |
Loans I Hold |
Yes |
No |
____________________________ |
__________________________ |
Liens I Hold |
Yes |
No |
____________________________ |
__________________________ |
Notes I Hold |
Yes |
No |
____________________________ |
__________________________ |
Credit Card #1 |
Yes |
No |
____________________________ |
__________________________ |
Credit Card #2 |
Yes |
No |
____________________________ |
__________________________ |
Credit Card #3 |
Yes |
No |
____________________________ |
__________________________ |
Personal Property, Effects &
Valuables |
|
|
|
Location |
Wish to Go To: |
Special Instructions |
1) |
_____________ |
______________ |
____________________ |
2) |
_____________ |
______________ |
____________________ |
3) |
_____________ |
______________ |
____________________ |
4) |
_____________ |
______________ |
____________________ |
5) |
_____________ |
______________ |
____________________ |
6) |
_____________ |
______________ |
____________________ |
7) |
_____________ |
______________ |
____________________ |
8) |
_____________ |
______________ |
____________________ |
9) |
_____________ |
______________ |
____________________ |
10) |
_____________ |
______________ |
____________________ |
MY Insurance Information |
|
|
|
Name of Company, Union, Organization, etc.,
paying MY death benefit |
Type of Policy |
Location of Policy |
Policy Number |
1) |
______________ |
____________ |
________________ |
2) |
______________ |
____________ |
________________ |
3) |
______________ |
____________ |
________________ |
4) |
______________ |
____________ |
________________ |
5) |
______________ |
____________ |
________________ |
Long Term Health Care |
______________ |
____________ |
________________ |
Home Owner |
______________ |
____________ |
________________ |
Automotive |
______________ |
____________ |
________________ |
Accident |
______________ |
____________ |
________________ |
Group |
______________ |
____________ |
________________ |
Membership |
______________ |
____________ |
________________ |
Union |
______________ |
____________ |
________________ |
ADDITIONAL INSURANCE INFORMATION
|
MY Wills & Trusts |
|
|
Location of Documentation |
Description of Type & Contact for Information |
MY Will |
Yes |
No |
________________________ |
_____________________ |
My Living Will |
Yes |
No |
________________________ |
_____________________ |
MY Trust |
Yes |
No |
________________________ |
_____________________ |
Other #1 |
Yes |
No |
________________________ |
_____________________ |
Other #2 |
Yes |
No |
________________________ |
_____________________ |
Other #3 |
Yes |
No |
________________________ |
_____________________ |
Click for: [WORK
FORMS PAGE THREE-MY
Burial/Mausoleum/Cremation Arrangements]
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